Procedure to add a crease to make eyes look bigger is back in the news - and still controversial in Asian American community

Published 12:05 pm, Friday, October 4, 2013

Julianne Chai had eyelid surgery 20 years ago but did not feel comfortable saying so until more than a decade later. While some see it as a cultural taboo, Chai believes it is more accepted now.

Julianne Chai had eyelid surgery 20 years ago but did not feel comfortable saying so until more than a decade later. While some see it as a cultural taboo, Chai believes it is more accepted now.

Photo: Russell Yip, The Chronicle

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Julianne Chai had eyelid surgery 20 years ago but did not feel comfortable saying so until more than a decade later. While some see it as a cultural taboo, Chai believes it is more accepted now.

Julianne Chai had eyelid surgery 20 years ago but did not feel comfortable saying so until more than a decade later. While some see it as a cultural taboo, Chai believes it is more accepted now.

Photo: Russell Yip, The Chronicle

Eyelid surgery a controversial procedure

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After her eyelid surgery in June, Ly Duong stepped outside into a whole new world.

"It felt funny because my eyes were so different," she said. "I saw more light."

She waited eight days for the redness and puffiness to fade before she made the big reveal. She posted a self-portrait on Facebook that highlighted her newly creased eyelids.

"I put, 'Oh yeah, it feels good to have big eyes,' " she said. "One of my best guy friends said, 'Oh, my God, what did you do?' I told him I got my eyelids done. He said, 'Before, you looked like a peasant, and now you look like a princess.' "

Duong, 28, a hair and makeup stylist from San Jose, has no qualms telling friends and clients about her surgery, especially in the diverse Bay Area.

Cosmetic eyelid surgeries have long been popular in Asia, particularly in South Korea. Patients whose eyelids don't have a crease or whose crease is hard to see can get an incision along the eyelid to make a new crease, so the eye appears bigger.

The procedure also grew popular in the U.S. over the past several decades and remains a touchy, racially charged subject. But among Bay Area Asian Americans who were born in the U.S. or who immigrated at a young age, opinions are split on the matter: Some say they should avoid the surgery and embrace their heritage, while others say it is less of a taboo because they know more people who've had it done.

The long-smoldering debate over the procedure flared up again last month when Julie Chen, the television host of "Big Brother," said she had the surgery 18 years ago at the encouragement of her agent after her boss in Ohio said her eyes looked too heavy for her to be a news anchor.

Chen's admission struck Jenny Lu, a 20-year-old UC Berkeley student and story editor at Hardboiled, a student-run magazine dealing with Asian American issues.

"If the deeper intention behind wanting bigger eyes has to do with beauty, then it ties back to this Western image of what's considered beautiful," Lu said. "It's something that is a big concern in the Asian community. If people see big eyes as beautiful and small eyes as something they want to change, it really perpetuates Asian American stereotypes of not belonging."

The surgery's stigma - that those who get it abandon their heritage - makes it hard to find people who admit they had it but easy to find people with opinions on it.

"Nobody ever talks about it when they have it," said Lisa Wang, 24, a San Franciscan who grew up in Plano, Texas. When one girl from her high school came back from a summer in China with different-looking eyelids, some classmates who weren't familiar with the surgery asked what happened. "She told people it must have been something in the water, which is a pretty weird response," Wang said.

Wang added: "I've started to come around to the idea that if you have the means to do something that gives you a significant confidence boost and improves your quality of life, then sure. But this still seems really weird to me. It seems a little bit racially self-hating, to be honest, and the fact that people are reluctant to talk about it compounds that."

It's difficult to pin down statistics on the surgery among Asian Americans because plastic surgery statistics don't often categorize patients by race. But in a 2o12 national survey, a smaller percentage of surgeons - 44 percent, down from 61 percent in 2008 - listed eyelid surgery as the most popular procedure among their Asian American patients.

Bay Area surgeons say eyelid surgery is still popular but that patients now want the results to be subtler.

"Patients used to come in and they would want Westernized eyelids - 'I want the fold,' " said Carolyn Chang, a San Francisco surgeon. "I don't get that request nearly as much as I used to 10 years ago."

The procedure used to be "more aggressive" in the '70s through the '90s, said Chase Lay, a surgeon in San Jose whose practice is almost all eyelid surgeries on Asian American patients. Surgeons used to remove more skin, or creases were made deeper and were set farther away from the edge of the eyelid.

When Janet Huynh, 34, contemplated getting the surgery, she looked to her family. Her mother, grandmother and several aunts all had surgery to add a fold, but "they went extreme," said Huynh, born and raised in San Jose.

"They were the first to settle here," she said. "They may have felt that pressure."

Huynh was looking for something "more natural," and other women echoed the same wish. But not so natural that she decided against the procedure. When Huynh came out of surgery last year, she texted a friend: "Hey, guess what I got done." The response: "You're kidding. I just got it done, too."

Parents sometimes guide their children toward the procedure, especially young men.

"The younger men tend to be 18 or 22, and they're not really bringing themselves in. Their parents will," said Lay. "They'll say, 'I believe that he'll do better in college or in the workforce.' Some parents are very up-front about wanting their children to have the best shot possible at the best spouse possible."

Wang's boyfriend, 25-year-old Brian Yeh, said that his mother used to joke about buying him eyelid surgery after high school graduation. But even in jest, her caveat was always that the surgery would aim to make his eyes bigger but not add a crease.

Women who told The Chronicle about getting the surgery dismissed the racial connotation and said the choice was purely for themselves. Many said it helped with makeup application; almost all said they wish they'd gotten it sooner so they could enjoy it longer.

"It's always been my dream to have it," said Duong, the makeup artist. "I couldn't replicate the looks I saw in makeup catalogs or tutorials."

Julianne Chai, a 39-year-old Korean American from El Cerrito, said she "always had double-eyelid envy" growing up in Milpitas. She would wear a tiny piece of tape on her eyelid - a quick-fix way to add a crease - and carried a roll of Scotch tape and little scissors in her purse at all times.

She had the surgery done while studying abroad in South Korea. When she came back, people asked her what happened, and, embarrassed, she told them it was just the result of years of tape-wearing. In her 30s, she felt more comfortable telling the truth.

Every once in a while, she'd be told it was a "sellout thing to do," she said.

"There's a part of me that thinks I should embrace my Asian eyelids and be content with what God gave me," she said. "But I feel it's much more accepted now. I feel like all Korean women at some point consider it."

Bigger, creased eyes may be considered more beautiful, but no one wants them to make themselves look more Caucasian, said D. Nguyen, a 36-year-old woman from Sunnyvale who had the procedure last year.

"Believe me, Vietnamese people don't want to look like a white person," Nguyen said. "We don't want to look Caucasian. We just want to look more beautiful."

Eyelid lift facts

How it's done: A surgeon cuts open the eyelid where the crease will be created and removes some skin, and occasionally some fat, before closing the incision; sutures are removed in a week. Another option involves making a series of small slits along the eyelid that are then tightened and closed.

Cost: Around $3,800

Recovery time: Most patients can go back to work in a week, some sooner. Some redness and puffiness may last longer. After several months, the only sign of the surgery should be a fine line on the lid that is visible when the eyes are closed.

How common is it? Blepharoplasty (any kind of eyelid lift), was the third-most-popular facial plastic surgery procedure in the United States in 2012, according to the American Academy of Facial Plastic and Reconstructive Surgery. In 2012, 44 percent of surgeons surveyed said blepharoplasty was the most popular procedure among Asian Americans, down from 61 percent in 2008.

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